title: Immediate anaphylactic death following antibiotics injection: splenic eosinophilia easily revealed by pagoda red stain.
abstract: The comparison of 4 cases of immediate anaphylactic death following the intramuscular injection of antibiotics (different types of penicillin or cephalosporins) with 4 cases of immediate non-anaphylactic death (induced by different causes) recognized splenic eosinophilia, as the main feature for the differential diagnosis, in agreement with isolated previous studies. The use of a stain (pagoda red) little known and seldom employed in Pathology and in Forensic Medicine, showed the concomitant massive presence (immunohistochemically confirmed) of mast cells and degranulated mast cells, the latter mainly located in splenic sinuses. The whole of our findings led us to consider the spleen as the possible shock organ in man. Waiting for further judgment on our hypothesis, we seized the opportunity to remark the employment of the pagoda red stain when the contemporary demonstration of eosinophils, mast cells and degranulated mast cells is required.
authors.affiliation: Department of Diagnostic Services, Pathology and Legal Medicine, Section of Legal Medicine, University of Modena and Reggio Emilia, Modena, Italy. nicoletta.trani@alice.it
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Trani
authors.forename: Luca Reggiani
authors.initials: LR
authors.lastname: Bonetti
authors.forename: Giorgio
authors.initials: G
authors.lastname: Gualandri
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Barbolini
mesh_terms: D000368:Aged; D000707:Anaphylaxis / Q000139:chemically induced* / Q000175:diagnosis; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016022:Case-Control Studies; D004396:Coloring Agents; D004487:Edema / Q000473:pathology; D004802:Eosinophilia / Q000473:pathology*; D004804:Eosinophils / Q000473:pathology; D005260:Female; D049429:Forensic Pathology / Q000379:methods; D006801:Humans; D007150:Immunohistochemistry; D007273:Injections, Intramuscular; D008297:Male; D008407:Mast Cells / Q000473:pathology; D008875:Middle Aged; D009930:Organic Chemicals; D013154:Spleen / Q000473:pathology; D013158:Splenic Diseases / Q000473:pathology*; D013194:Staining and Labeling
chemical_list: D000900:Anti-Bacterial Agents; D004396:Coloring Agents; D009930:Organic Chemicals; C037381:pagoda red no. 9